Decisive Criteria Between Stapedotomy and Cochlear Implantation in Patients with Far Advanced Otosclerosis

Kabbara, Bilal; Gauche, Clement; Calmels, M.; Lepage, Benoît; Escudé, B.; Déguine, Olivier; Fraysse, Bernard; Marx, Mathieu

doi:10.1097/mao.0000000000000692

Cited by 38 publications

(85 citation statements)

References 24 publications

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“…8,26 Patients with less retrofenestral sclerosis, previous benefit from hearing aid use, and speech recognition scores above 50% have a higher success rate, whereas severe retrofenestral sclerosis with basal turn ossification and speech recognition scores less than 30% have been associated with a lower success rate. 15 The variability in outcomes and the limitations of our study restrain us from making a solid recommendation. Treatment decisions rest on surgeons and informed patients, who should receive adequate counseling regarding the factors covered here.…”

Section: Intervention For Advanced Otosclerosismentioning

confidence: 93%

Stapedotomy vs Cochlear Implantation for Advanced Otosclerosis

Abdurehim

Lehmann

Zeitouni

2016

Otolaryngol.--head neck surg.

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Cochlear implantation leads to a statistically greater and consistent improvement in speech recognition scores. Stapedotomy is not universally effective; however, it yields good results comparable to cochlear implantations in at least half of patients. For cases of unsuccessful stapedotomy, the option of cochlear implantation is still open, and the results obtained through salvage cochlear implantation are as good as those of primary cochlear implantation.

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Section: Intervention For Advanced Otosclerosismentioning

confidence: 93%

Stapedotomy vs Cochlear Implantation for Advanced Otosclerosis

Abdurehim

Lehmann

Zeitouni

2016

Otolaryngol.--head neck surg.

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“…Deciding among these options depends on several factors including the degree of residual hearing in the contralateral ear, the duration of hearing deprivation, and patient preference [Kabbara et al, 2015].…”

Section: Introductionmentioning

confidence: 99%

Cochlear Implant Users with Otosclerosis: Are Hearing and Quality of Life Outcomes Worse than in Cochlear Implant Users without Otosclerosis?

et al. 2018

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Background: The otosclerotic process may influence the performance of the cochlear implant (CI). Difficulty in inserting the electrode array due to potential ossification of the cochlea, facial nerve stimulation, and instability of the results are potential challenges for the CI team. Objectives: To evaluate hearing results and subjective outcomes of CI users with otosclerosis and to compare them with those of CI users without otosclerosis. Method: Retrospective review of 239 adults with bilateral profound postlingual deafness who underwent unilateral cochlear implantation between 1992 and 2017. Hearing and speech understanding were assessed via pure-tone audiometry and speech perception tests. Subjective outcomes were assessed via the Nijmegen Cochlear Implant Questionnaire (NCIQ), the Glasgow Benefit Inventory (GBI), and the Hearing Implant Sound Quality Index (HISQUI₁₉) at 6 months, 12 months, and at the last follow-up. Results: Subjects were 22 CI users with otosclerosis and 217 without otosclerosis. Both groups had a similar duration of deafness and age at CI implantation. Results did not significantly differ according to group: no significant intergroup difference was found regarding the frequency of complete electrode insertion, facial stimulation, reimplantation, or PTA4 scores at the last follow-up. Regarding speech perception, no significant intergroup difference was found on any test or at any interval. Further, subjective outcomes, as measured by the GBI, NCIQ, and HISQUI₁₉, did not significantly differ between groups. Conclusions: Adults with otosclerosis and profound hearing loss derive significant benefit from CI use. Audiological and self-reported outcomes are not significantly different from that of other CI users with postlingual deafness.

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“…[2][3][4] However, there is also much evidence to suggest that stapes surgery can restore hearing to acceptable levels in patients with similar ''profound'' hearing loss, especially when combined with a well-fitted hearing aid. [5][6][7][8][9][10] Furthermore, whereas CI can be time-consuming and physically invasive, stapes surgery is minimally invasive and cost-effective. If stapes surgery is not beneficial, CI or revision stapes surgery can be performed.…”

Section: Introductionmentioning

confidence: 99%

Stapes Surgery for Profound Hearing Loss Secondary to Otosclerosis

et al. 2019

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The objective of this study is to evaluate stapes surgery in patients with otosclerosis and ''profound'' hearing loss. This means they meet hearing threshold criteria for cochlear implantation (CI). We performed a retrospective study and patient questionnaire. The results from 33 patients (35 ears) were recorded (mean age: 63.6, range: 40-85). The primary outcome measure was hearing thresholds recorded before and after surgery at 0.5, 1, 2, 3, and 4 kHz. Hearing thresholds at 2 and 4 kHz were also analyzed. Glasgow Benefit Inventory (GBI) was used in 21 patients to assess life quality changes. Hearing thresholds improved in 80% of ears (mean improvement, 26.3 dB), were unchanged in 11.4%, and worsened in 8.6%. Mean GBI score was þ20.7. Hearing aid use decreased in 23.8% and ceased in 28.6%. One patient subsequently underwent CI. For patients with profound otosclerosis, stapes surgery provides a quantitative improvement in hearing thresholds and improvement in quality of life, with reduced reliance on hearing aids. This avoids CI, auditory rehabilitation, and a change in quality and tonality of sound.

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Decisive Criteria Between Stapedotomy and Cochlear Implantation in Patients with Far Advanced Otosclerosis

Abstract: Although cochlear implantation gives better overall results, stapedotomy with hearing aids can still be very effective in the management of patients with far-advanced otosclerosis. It should therefore be proposed as a first-line treatment.

Cited by 38 publications

References 24 publications

Stapedotomy vs Cochlear Implantation for Advanced Otosclerosis

Stapedotomy vs Cochlear Implantation for Advanced Otosclerosis

Cochlear Implant Users with Otosclerosis: Are Hearing and Quality of Life Outcomes Worse than in Cochlear Implant Users without Otosclerosis?

Stapes Surgery for Profound Hearing Loss Secondary to Otosclerosis

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